Abstract
Abdominal adhesions, whether caused by peritoneal trauma, radiation, infection, or a congenital condition, are associated with a wide range of complications. These complications include chronic abdominal or pelvic pain, infertility, and adhesive small bowel obstruction. Such adhesions render re-operation difficult, with attendant risks of inadvertent enterostomy and increased operation time. The purpose of this study was to investigate the potential of hyperbaric oxygen (HBO) therapy in the prevention of abdominal adhesions in an experimental animal study. A laparotomy was performed on Wistar rats to induce the formation of adhesions on the cecum and the intra-abdominal area (1 × 2 cm). A superficial layer of the underlying muscle from the right abdominal wall was also shaved and prepared for aseptic surgery. The rats were divided into four groups according to the duration of HBO therapy; five additional groups were designated according to the conditions of HBO therapy. When the rats were evaluated according to adhesion area and grade, a statistically significant difference was observed between the control and HBO treatment groups (p < 0.005). Results from this study suggest that HBO treatment could reduce adhesion formation; and further suggest that HBO therapy may have therapeutic potential in the treatment of postoperative peritoneal adhesion.
Highlights
Abdominal surgery often leads to adhesion between tissues and organs
Intra-abdominal adhesions caused by inflammatory or congenital alterations [4] are associated with a wide range of complications including female infertility as well as chronic abdominal and adhesive small bowel obstruction [5]
It has been hypothesized that hyperbaric oxygen (HBO) can mediate postoperative adhesion formation in the intra-abdominal region
Summary
Abdominal surgery often leads to adhesion between tissues and organs. Menzies and Ellis have reported that up to 93% of patients develop primary abdominal adhesions following laparotomy [1].Post-surgical abdominal adhesions are more likely to form in women with peritoneal trauma [2], or as a result of the host response to infection following abdominal surgery [3]. Abdominal surgery often leads to adhesion between tissues and organs. Menzies and Ellis have reported that up to 93% of patients develop primary abdominal adhesions following laparotomy [1]. Post-surgical abdominal adhesions are more likely to form in women with peritoneal trauma [2], or as a result of the host response to infection following abdominal surgery [3]. In addition to the complications outlined above, adhesions may result in inadvertent enterotomy at reoperation, prolonged operation times, increased clinical workload, and high financial costs [8]. Significant advances have been made in terms of adhesion prevention, such as the bioresorbable physical barrier Seprafilm® (Genzyme Corporation, Cambridge, MA, USA) [9] and the non-absorbable Gore-Tex surgical membrane barrier (Preclude®, WC Gore, NJ, USA) [10]. Screening of potential tools is both time consuming and expensive
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